Provider Demographics
NPI:1215903026
Name:HERNANDEZ DENTON, GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:HERNANDEZ DENTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 CALLE WILSON
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2357
Mailing Address - Country:US
Mailing Address - Phone:787-726-7380
Mailing Address - Fax:787-268-1439
Practice Address - Street 1:1475 CALLE WILSON
Practice Address - Street 2:SUITE 3B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2357
Practice Address - Country:US
Practice Address - Phone:787-726-7380
Practice Address - Fax:787-268-1439
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6504174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist